Ala. Code tit. 22, ch. 56

Rights of Consumers of Mental Health Services

The Alabama Mental Health Consumers' Rights Act establishes the rights of individuals receiving mental health services across inpatient, residential, and outpatient settings operated or contracted by the Alabama Department of Mental Health. Providers—including state facilities, community mental health centers, and contracted agencies—must ensure consumers receive individualized, humane, and rights-respecting care, and must develop written policies prohibiting abuse, exploitation, and neglect. The Department is required to establish certification standards and compliance monitoring teams that include consumers and family members. Physicians in private practice are largely exempt from the written policy requirements.

[§ 22-56-1] Section 22-56-1 Short Title.
This chapter shall be known and may be cited as the “Alabama Mental Health Consumers’ Rights Act.”

[§ 22-56-2] Section 22-56-2 Definitions.
As used in this chapter, the following terms shall have the following meanings:
(1) CONSUMER. A person who receives or uses mental health services.
(2) DEPARTMENT. The Alabama Department of Mental Health.
(3) FAMILY MEMBER. A person within the immediate family or a legal guardian of a mental health consumer.
(4) MENTAL HEALTH SERVICES. Services designed to treat or deal with persons with mental illness.
(5) MENTAL ILLNESS. A psychiatric disorder of thought or mood, or both, which significantly impairs judgment, behavior, capacity to recognize reality, or ability to cope with the ordinary demands of life. “Mental illness” as used herein specifically excludes the primary diagnoses of epilepsy, intellectual disability, substance abuse including alcoholism, or a developmental disability, or any combination thereof.
(6) PROGRAM. A program for providing mental health services.
(7) PROVIDER. Any agency, corporation, or individual who provides inpatient, residential or outpatient mental health services to a consumer or consumers, provided that this chapter shall only apply to physicians licensed to practice medicine to the extent that medical services to individuals covered by the chapter must be provided in accordance with established standards of medical care.

[§ 22-56-3] Section 22-56-3 Legislative Declarations.
The Legislature declares that mental health services shall be individualized, empowering, culturally relevant and diverse, flexible, and include natural supports. Mental health services shall also be provided in a way which is normalizing as well as respectful of the rights, responsibilities, and feelings of each consumer. Mental health services shall also focus on enabling individuals to maintain responsibility to the greatest extent possible for setting their own goals, directing their own lives, and acting responsibly as members of their community.

[§ 22-56-4] Section 22-56-4 Rights.
(a) Consumers of mental health services have the same general rights as other citizens of Alabama. These rights include but are not limited to the following:
(1) The right to exercise rights as a citizen of the United States and the State of Alabama.
(2) The right to be served through general services available to all citizens.
(3) The right to choose to live, work, be educated, and recreate with persons who do not have disabilities.
(4) The right to be presumed competent until a court of competent jurisdiction, abiding by statutory and constitutional provisions, determines otherwise.
(5) The right to vote and otherwise participate in the political process.
(6) The right to free exercise of religion.
(7) The right to own and possess real and personal property. Nothing in this section shall affect existing laws pertaining to conveyance of real or personal property.
(8) The right to make contracts.
(9) The right to obtain a driver’s license on the same basis as other citizens.
(10) The right to social interaction with members of either sex.
(11) The right to marry and divorce.
(12) The right to be paid the value of work performed.
(13) The right to exercise rights without reprisal.
(b) In addition, the rights of consumers of mental health services within inpatient, residential, or outpatient settings include, but are not limited to, the following:
(1) The right to access individualized mental health services.
(2) The right to participate in the treatment planning process, with material involved in this process presented in language appropriate to the consumer’s ability to understand.
(3) The right to be accorded human respect and dignity on an individual basis in a consistently humane fashion.
(4) The right to be fully informed, on an individual basis, when needed, concerning services provided, with information presented in a setting and in language appropriate to the consumer’s condition and ability to understand.
(5) The right to a statement of any applicable charges for mental health services, itemized when possible, and the right to be informed of any limitations placed on the duration of services.
(6) The right to confidentiality of all information in the consumer’s mental health, medical, and financial records.
(7) The right to access upon request all information in the consumer’s mental health, medical, and financial records, unless a clinical determination has been made by professional staff that access would be detrimental to the consumer’s health.
(8) For those consumers legally committed to facilities or programs, the right to be informed of one’s commitment status including the requirements of the commitment, if any, and the length of the commitment.
(9) The right to be free from any physical, verbal, sexual, or psychological abuse, exploitation, coercion, reprisal, intimidation, or neglect.
(10) The right to make an individual, written decision to consent or refuse to participate in research or experimentation, based upon information which is presented in a non-threatening environment and in language appropriate to the consumer’s condition and ability to understand. The information presented shall follow the General Requirements for Informed Consent as cited under the Code of Federal Regulations 45 C.F.R. 46.116, Department of Health and Human Services, National Institute of Health, Office for Protection from Research Risks: “Protection of Human Subjects.”
(11) The right to be informed specifically of the procedures for initiating a complaint or grievance procedure and the applicable appeals process, including the means of requesting a hearing or review of the complaint.
(12) The right to be informed of the means for accessing advocates, ombudsmen, or rights protection services within the program and, as applicable, the State of Alabama mental health system, the Alabama Department of Human Resources, the federal advocacy system, and other advocacy services. Access must be allowed without reprisal.
(13) The right to have access to courts and attorneys.
(14) The right to enforce rights in a court of competent jurisdiction or appropriate administrative proceeding.
(15) The right to use services in a safe and humane environment.
(16) The right to be free from seclusion, physical restraints, drugs, or other interventions administered for purposes of punishment, discipline or staff convenience. Restraint, seclusion, or other intrusive treatments may be administered only in situations defined by established standards of medical care taking into consideration the health status of the individual and by applicable governing standards.
(17) The right to refuse mental health services without reprisal except when refusals are not permitted under applicable law.
(18) In residential or inpatient programs, the right to privacy.
(19) In residential or inpatient programs, the right to have access to and privacy of mail, telephone communications, and visitors, unless legally restricted.
(20) In residential or inpatient programs operated or certified by the State of Alabama, the right to adequate food and shelter.
(21) In residential or inpatient programs operated or certified by the State of Alabama, the right to access dental and medical care, including vision and hearing services.
(22) The right to conditions of mental health services which are supportive of each consumer’s personal liberty and restrict liberty only to the extent necessary, consistent with each consumer’s treatment needs, applicable requirements of law, and applicable judicial orders. This right applies to general rights within a clinical setting as well as to specific rights enumerated in subsection (b).
(23) For those individuals legally committed to mental health services operated by the State of Alabama or community or regional mental health centers, the right to inclusion in the community with appropriate and adequate supports, on completion of or in conjunction with the terms of commitments.

[§ 22-56-5] Section 22-56-5 Department to Establish Official Standards for Certification.
In order to ensure that consumers of mental health services through state facilities, community mental health centers, and other providers under contract to the department receive individual treatment and that rights delineated in Section 22-56-4 and elsewhere in state and federal law are consistently observed within mental health programs operated by the providers, the department shall establish within 180 days of January 1, 1996, official standards for certification to be observed by all state facilities, community mental health centers, and other providers under contract to the department. These standards shall be developed with the active participation of mental health providers, consumers and family members of consumers. The department shall establish teams to monitor the compliance with these standards by state facilities, community mental health centers, and providers under contract to the department, and consumers and family members shall be significantly represented on the teams.

[§ 22-56-6] Section 22-56-6 Abuse, Exploitation, Neglect - Penalties; Reporting to Agencies.
Any provider who abuses, exploits, or neglects a consumer in his or her care shall be subject to the civil and criminal remedies and penalties prescribed in Alabama law. All instances of abuse, exploitation, or neglect, as defined by Alabama law, shall be reported to appropriate licensing or investigative agencies, in a manner consistent with Alabama law.

[§ 22-56-7] Section 22-56-7 Abuse, Exploitation, Neglect - Providers to Implement Written Policies and Procedures.
All providers of mental health services in Alabama shall develop and implement written policies and procedures that prohibit abuse, exploitation, or neglect of consumers in programs operated by the providers. At a minimum, these policies and procedures shall accomplish the following:
(1) Affirm and safeguard the rights of a consumer stated pursuant to this chapter.
(2) Ensure that prompt action is taken to prevent the potential of further abuse while an investigation is in process.
(3) Provide for an immediate and thorough investigation of all allegations of abuse, exploitation, or neglect by trained, experienced personnel delegated with all necessary authority. The status of all investigations shall be reported to the administrator(s) of the program or his or her designated representative on a continuous basis.
(4) Establish reasonable and appropriate corrective action, including education, training, and punishment for any program-affiliated individual who has been found responsible for abuse, exploitation, or neglect of consumers. All criminal violations shall be reported to the Office of the Attorney General, State of Alabama, or the local district attorney for consideration of further legal action.
(5) Prohibit the employment of individuals in any job involving care or services for consumers that are known to the provider to have a conviction of child, elder, patient, or resident abuse, exploitation, or neglect in any job involving care or services for consumers. The provider shall make a good faith effort to check the background of all persons hired in these jobs.
(6) Provide training and informational materials on consumers’ rights and on the prevention of abuse, exploitation, and neglect for administrators, mental health professionals, direct-care staff, and volunteers. Each new staff member shall demonstrate working knowledge of this information, and training shall be given on an ongoing basis for all the previously mentioned workers. When possible, ongoing training shall be provided by consumers and family members.

[§ 22-56-8] Section 22-56-8 Effect of Chapter on Established Standards of Medical Care; Applicability of Written Policies and Procedures.
This chapter shall not be interpreted or construed to alter, expand, or diminish established standards of medical care applicable to physicians licensed to practice medicine. Notwithstanding any provision of this chapter to the contrary, the requirement to develop and implement written policies and procedures as outlined in Section 22-56-7 shall not apply to the private offices of physicians licensed to practice medicine.

[§ 22-56-9] Section 22-56-9 Construction with Other Law.
This chapter shall not override any provisions of the Adult Protective Services Act, pursuant to Chapter 9 (commencing with Section 38-9-1) of Title 38, or the Child Abuse Reporting Act, Chapter 14 (commencing with Section 26-14-1) of Title 26, and shall be read in para materia with those provisions.

[§ 22-56-10] Section 22-56-10 No Reduction or Expansion of Rights Beyond Rights Guaranteed Other Persons.
Provided that nothing in this chapter shall reduce or expand the rights of mental health consumers in Alabama beyond the rights guaranteed to any other person under the statutes or Constitution of the United States and Alabama statutes or Constitution of Alabama of 1901.